NCESP Individual/Associate Membership Form

Please print out this form, complete all sections and mail it, along with your membership payment, to the address provided below. For a PDF copy of this form see the Related Items section in the right column.

MAILING INFORMATION:

____________________________________________________
Last Name First Name Middle Initial

Address_____________________________________________

City_______________________State______ Zip ___________

Home Phone:________________________

Work Phone:________________________

Fax Number:________________________

E-mail Address:_______________________________________

JOB TITLE____________________________________

JOB CATEGORY: Please check the appropriate classification

_____Building and Grounds Maintenance and Repair

_____Security Services

_____Food Services

_____Health and Student Services

_____Paraprofessional

_____Secretarial, Clerical, Administrative Services

_____Technical Services

_____Trades, Crafts, Machine Operators

_____Transportation, Delivery, Vehicle Mechanics

GRADE LEVEL: Please check the appropriate levels

_____Pre-K

_____K-12

_____Higher Ed

LEADERSHIP POSITIONS HELD:

Local_______________________________________________

State_______________________________________________

National_____________________________________________

MEMBERSHIP INFORMATION: Please check one

_____I am a NEW member

_____I am a renewing member

PAYMENT INFORMATION: Please check one

_____I am ESP and want to have an Individual, voting membership ($20.00)

_____I am ESP and want to have an Associate, non-voting membership ($10.00)

_____I am Not ESP and would like to have an Associate, non-voting membership ($10.00)

Please make your check payable to the NCESP and mail a copy of this membership form to :

Attn: NCESP

National Education Association

Center for Governance
1201 16th Street, NW # 813

Washington, D.C. 20036

****NOTE****

Only checks and money orders are acceptable. PLEASE DO NOT SEND CASH.

Please keep a copy of this form for your own records.

NOTE: This form is for Individual and Associate members. If you are joining as an ESP Organization, please use the Organization Membership Form.

National Council for Education Support Professionals

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RELATED ITEMS

Click here to download a PDF copy of the NCESP Individual/Associate Membership Form.

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